PresbyMAX is usually not ideal when early cataracts are already present; lens‑based procedures typically give a better long‑term solution.
Why early cataract reduces suitability
The lens is starting to limit vision.
- Cataracts will likely progress, eventually requiring cataract surgery
- Corneal laser cannot correct lens opacity or increased scatter
- Later cataract surgery may compromise prior presbyopic laser effect
- Refractive lens exchange can address both presbyopia and cataract together
- Risk of needing two separate operations instead of one combined lens procedure
Possible exceptions
Occasionally corneal laser is deferred rather than excluded.
- Very mild lens changes without functional impact
- Strong preference to delay intraocular surgery despite counselling
- Clear understanding that future cataract surgery may alter results
- Regular monitoring of lens status after PresbyMAX
- Decision taken jointly with the surgeon after weighing all options
